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Table 2 Literature reviews on the aetiology of DTI in transtibial prosthetic users

From: Exploring the role of transtibial prosthetic use in deep tissue injury development: a scoping review

Autor and year


Aetiological factor

Qualitative results

Mak et al. 2001 [40]

Overview over current knowledge about biomechanics in TTAa s

Deformation, impaired

lymphatic system,


- Skeletal movement and friction lead to soft tissue deformation during gait

- Stress and deformation affect cellular and tissue function mechanically and via impairment of ancillary systems

- Magnitude, direction, distribution, duration, loading rate are crucial

- Possible accumulative effect of repetitive stress

Mak et al. 2010 [9]

Overview over tissue response to loading

Deformation, impaired lymphatic system, ischemia, ischemia-reperfusion

- Immediate muscle damage by direct mechanical insult or over longer period by ischemia

- Reperfusion exacerbates damage by oxidative stress and inflammation

- Damage may accumulate if insufficient recovery time

Bader et al. 2019 [26]

Analysis of bioengineering tools for device related soft tissue damage

Deformation, lymphatic drainage, ischemia, ischemia reperfusion injury

- Direct deformation, impaired lymphatic drainage, disrupted microvasculature and ischemia reperfusion as aetiological factors

- High inter-patient variability

  1. a Transtibial amputee